MGHD 2023

Introduction: This research aims to assess the mental health needs of young people (YP) aged 15 to 24 living with HIV in Kigali. The specific objectives of this research are to assess the prevalence of MH conditions among YPL with HIV in SHCs (Selected Health Centers) Kigali, Rwanda, to examine the risk factors associated with MH conditions among YP aged 15 to 24 living with HIV in SHCs in Kigali, Rwanda, to determine MH services availability and treatment types offered at the health facility to YP aged 15 to 24 years living with HIV in SHCs in Kigali,Rwanda. Methods: The research utilized a quantitative cross-sectional design and collected data through a survey questionnaire. Participants were selected using stratified sampling techniques, resulting in a sample of 265 young people living with HIV. Pregnant and breastfeeding YP were excluded from the study. Descriptive and inferential statistics, including bivariate and multivariate analyses, were performed using the latest version of SPSS 26.0. Results: The study revealed a high prevalence of mental health conditions among the participants, with depression affecting 45.7% of YP, anxiety affecting 33.2%, and Post-Traumatic Stress Disorder (PTSD) affecting 27.9%. In relation to depression, the study found that individuals who took less than 30 minutes to reach healthcare facilities had a lower likelihood of experiencing depression (OR = 0.546, 95% CI: 0.316 to 0.942). Being bullied more than half the days was strongly associated with increased depression risk (OR = 9.527, 95% CI:1.318 to 68.839). For anxiety, individuals with primary education had a higher likelihood of experiencing anxiety (OR = 2.047, 95% CI: 0.429 to 9.767). Not engaging in sexual activity in the last three months was associated with a reduced likelihood of PTSD (OR = 0.317, 95% CI:0.144 to 0.700). Having three meals per day was significantly associated with increased PTSD risk (OR = 3.265, 95% CI: 1.481 to 2.461). Conclusion and recommendations: The study emphasizes the high prevalence of mental health conditions among young people (YP) living with HIV and highlights the need for tailored mental health services. Recommendations include integrating mental health services into existing HIV care frameworks is vital to ensure comprehensive support for YP living with HIV.

Background Men who have sex with men (MSM) and transgender women (TGW) are disproportionately affected by HIV worldwide and in Rwanda. Additionally, MSM and TGW living with HIV are subjected to intersecting stigmatization of their sexual orientation, gender identity, and HIV status. Interventions have been put in place to avail HIV services to everyone including these vulnerable populations in Rwanda. However, the stigma against people living with HIV, MSM, and TGW and their overlap impedes the efforts. Therefore, the purpose of this study was to explore the effect of intersectional stigma on the use of HIV services among MSM and TGW living with HIV in Kigali, Rwanda. Methods This is a qualitative phenomenological study. In-depth interviews were conducted with MSM and TGW living with HIV to explore their lived experiences of intersectional stigma and the use of HIV services. Results Seventeen in-depth interviews (nine MSM and eight TGW) were conducted in total. The findings yielded four themes that highlighted how intersectional stigma affects the use of HIV services among MSM and TGW living with HIV. Those themes are: 1. Internalized, anticipated, and experienced stigma negatively affects mental health and consequently the use of HIV services, 2. Social and employment discrimination exacerbate financial difficulties and negatively affect HIV services use, 3. Experienced stigma from healthcare providers contributes to mistrust and fear of disclosure leading to inadequate use of HIV services, 4. Resilience, social support, inclusive healthcare provision, and positive health outcomes have a positive effect on HIV services use. The results revealed the mechanisms through which the HIV services use are affected by multiple intersecting stigmas and therefore emphasize areas to address in HIV care engagement for MSM and TGW living with HIV. Conclusion The findings of this study highlight how intersectional stigma contributes to economic and mental health challenges among these populations which further exacerbates the barriers to accessing and utilizing HIV services effectively. Therefore, the findings recognize the unique experiences of these communities and emphasize the need for inclusive approaches to reduce stigma and its effect on health-seeking behaviors. By amplifying the voices of these communities, we contributed to the efforts toward achieving inclusive and equitable HIV services for all.